Accuracy of macroscopical assessment of gallbladder pathology: should we send all macroscopically benign gallbladders on pathological examination?
Abstract
Background: Gallbladder stones are the main reason for numerous gallbladder removal procedures. In many cases it is impossible to discover gallbladder carcinoma during the preoperative workup. Diffuse gallbladder wall thickening is usually the result of gallstones but may harbour carcinoma as well. The objective of our study was to estimate the accuracy of the intraoperative macroscopic examination for determination of a pathological process of the gallbladder.
Methods: We retrospectively examined 25 cases of the gallbladder carcinoma found in 4288 patients who underwent cholecystectomy in the period from 1993 to 2004. In each of those cases we determined whether a suspicion for carcinoma has been reported based on macroscopic examination.
Results: According to macroscopic examination of the gallbladder surgeon did not report any suspicion for the carcinoma in 52% of the cases.
Conclusions: Due to high inaccuracy of preoperative and intraoperative macroscopical assessment, pathological examination of the resected gallbladder is the only accurate method for the diagnosis of gallbladder carcinoma, as well as for staging and establishing the indication for extended surgical procedure.
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